University of Hawaii (UH) researchers seeking to prove whether getting a community involved in preventing Type 2 diabetes can reduce the risk for the disease is off to a promising start.

The scientists monitored health data from 392 people all over Oahu, but primarily in Waianae, including 259 individuals of Native Hawaiian or Pacific Island ancestry— those at highest risk in Hawaii for Type 2 diabetes.

The UH study also partnered with MAO Organic Farms in Waianae, which provides educational and employment opportunities to young people in the area, “interns” who work the land and also receive tuition waivers. It is a program that the researchers and the community-based organization suspected would improve health among the interns, because they are active, working the land in ways their ancestors did, consuming healthier food — farm fresh — and are getting an education. Many of the interns agreed to take part in the study. And it is among the interns that the preliminary results — measuring BMI, blood pressure, mental health, gut microbiome composition, diet, social economics, health behaviors and social network influences — showed a 60% decline in risk for Type 2 diabetes.

Watch a video HMSA Foundation produced about the study:

Note: JABSOM deeply respects the Native Hawaiian language, but to comply with law requiring our website to be accessible to people with disabilities, we are unable to use Hawaiian diacritical markings at this time, i.e. we are advised the marks are not able to be read by text readers for the vision impaired.

The study leaders are Dr. Alika Maunakea, a Waianae born Associate Professor at UH’s John A. Burns School of Medicine (JABSOM), an expert in epigenetics: the molecular interaction between the environment and genes, and how changes in this interaction are involved in diseases which are disproportionately prevalent in Native Hawaiian and Pacific Island populations. And Dr. Ruben Juarez, an Associate Professor in the UH Department of Economics and UH Economic Research Organization. He is a Mathematical Economist researcher with expertise in Social Networks and Behavior.

“Studies like ours allow grassroot community-based organizations that do not explicitly target health, but definitely impact it, to be valuable partners in the health care system,” said Dr. Maunakea. “That enables sustainable health care by shifting the focus from treatment to prevention-oriented approaches in the real-world.”

Maunakea and Juarez hope by the study’s end they can develop new methodologies for communities to assess the impact of their programs in a rigorous scientific manner, or as they put it, “enable communities to play a vital role in the health care ecosystem.” The scientists also hope that in the future, their study might be able to expand to other high-risk parts of the State.

Their overall aim is to collect data to capture the relationship between aina (land/environment) and ola (health/life) within social networks from individuals living in Waianae. Waianae and other communities where poor health is the highest in the State share some other factors associated with poor health: adults lacking a high school diploma, those 200% below the poverty level, those unemployed, those on Food Stamps, and those of Native Hawaiian/Pacific Island ancestry. However, these communities often are home to grassroot organizations, like MAO Organic Farms, that seek to mitigate these issues from a variety of holistic approaches and, in effect, can provide realistic solutions themselves to these unsustainable public health problems when enabled by evidence-based data of efficacy, as this study exemplifies.